Executive Function Training Research Articles

Executive Function Training Curriculum to Enhance Emotional Intelligence in Early Childhood: Theory Adaptation in Educational Design Research

Emotional intelligence (EI) is vital for early childhood development and is closely linked to executive function (EF). EF is a foundation of cognitive ability in early childhood. Educational design research (EDR) offers an adaptive methodology for curriculum development. This study aimed to (1) analyze and explore perspectives for designing an executive function training (EFT) curriculum to enhance EI, (2) design and develop the EFT curriculum, and (3) evaluate and reflect on the EFT curriculum. The research underscores the need to enhance EI, social skills, self-help abilities, and positive attitudes in early childhood students. Developed through a collaborative effort involving multiple stakeholders, the EFT curriculum aligns with Thailand's Ministry of Education standards. It significantly improves EI scores across six assessments of EI's five elements: self-awareness, self-regulation, motivation, empathy, and adeptness in relationships. The EFT curriculum emphasizes inhibitory control, shift/cognitive flexibility, emotional control, working memory, planning/organizing, and incorporating sleep to support cognitive and emotional development, a total of 150 hours. Developed with stakeholder input and rigorous design principles, the EFT curriculum prepares children for future learning and life challenges.

Design and development of a gamified cognitive training program targeting executive functions for older adults

With increased population aging, cognitive training has emerged as a popular intervention for combating age-related cognitive decline. Considering the purpose of cognitive interventions, the development of cognitive training programs typically focuses on properties that may enhance cognition, often neglecting the key element of user engagement. Consequently, many cognitive training studies have reported poor adherence and high participant attrition. To increase the likelihood of long-term cognitive benefits, there must be sustained use of the intervention (i.e., good training program adherence). Utilizing a research-through-design approach, this paper presents the design and development of a cognitive training program for older adults. Specifically, the primary focus was on outlining a conceptual framework for developing this program, which draws from gamification principles to foster motivation and enjoyment, as well as cognitive plasticity and transfer principles to foster cognitive engagement. Overall, the program encompasses gamified, adaptive, multidomain training of core executive functions (working memory, inhibitory control, and cognitive flexibility). This program will be the basis for future works exploring older adults’ experiences and preferences of cognitive training, and evaluating the efficacy of multidomain executive functions training in enhancing cognition and well-being in older age.

Impact of a cognitive training on reading of 6-year-old children

Numerous studies explore the effect of cognitive stimulation programmes on reading skills in children and adolescents, with mixed results. Although several studies support that the relationships established between executive functions and reading skills are more robust at early ages, when the process of formal reading acquisition is being consolidated, there are few studies that evaluate the impact of this type of interventions at the beginning of primary school. For this reason, the present pilot study investigates the possible effects of executive functions training on letter identification and decoding, as well as word and pseudoword reading. A cognitive training was carried out using the CogniFit platform in 12 typically developing 6-year-old children, comparing their performance with a control group of 28 children of the same age and similar socioeconomic status. This protocol took place over 8 weeks, with a mean of 19 minutes of training per week. The results obtained indicate that the experimental group showed a higher reading speed in letter recognition than the control group. However, no effect was found in the rest of the reading skills. These promising results indicate that additional research is needed to clarify the lack of convergence reported in the current scientific literature.

Interventions to Enhance Neurocognition for Common Mental Disorders: A Brief Review

Neurocognition, particularly executive functioning (EF), is crucial in psychiatric treatments due to its complex relationship with psychopathology. Cognitive-behavioral therapies (CBTs) show potential in enhancing neurocognitive functions (eg, inhibition, set-shifting, and working memory). Post-CBT changes in brain activation have been observed in regions such as the anterior cingulate cortex and middle frontal gyrus. Although CBTs improve attention and EF in various populations, they are less effective for traumatic brain injury patients. Mindfulness-based psychotherapies also enhance neurocognitive domains, especially in psychiatric populations. Tailored delivery methods, such as face-to-face sessions, may optimize therapeutic outcomes. EF and cognitive training are beneficial for those with attention-deficit/hyperactivity disorder. Integrating CBT with physical exercise can produce synergistic effects on neurocognition. Pharmacotherapies, particularly selective serotonin reuptake inhibitors, offer modest neurocognitive improvements by optimizing neurotransmitter pathways. Clear communication of intervention strengths and limitations is vital for managing patient expectations and enhancing care by targeting clinical, functional, and neurocognitive outcomes. [ Psychiatr Ann . 2024;54(9):e263–e267.]

Identifying Language Development in Children with ADHD: Differential Challenges, Interventions, and Collaborative Strategies.

Attention Deficit Hyperactivity Disorder (ADHD) significantly influences children's language acquisition and usage. This theoretical study explores the multifaceted impact of ADHD on language development, specifically focusing on reading and writing challenges. Existing research reveals that approximately 30% of children with ADHD show significant delays in reading proficiency. Additionally, about 40% of these children struggle with phonological processing, which directly impacts their reading and writing skills. Interventions targeting executive function training combined with phonics-based instruction have been shown to significantly improve language outcomes. This study introduces a comprehensive framework connecting these challenges to specific interventions and collaborative strategies, emphasizing the importance of a multi-disciplinary approach. This work provides perspectives on the specific connections between ADHD symptoms and language difficulties, offering detailed potential solutions based on empirical data. Moreover, it features the necessity of adopting integrated intervention strategies to advance academic outcomes and communicative competencies for children with ADHD, providing new understandings into effective educational practices.

Longitudinal changes in executive function in autism spectrum disorder: A systematic review and meta-analyses.

Individuals with an autism spectrum disorder (ASD) diagnosis show impairment in executive function (EF). However, findings are mixed regarding differences in the age effect on EF between autistic individuals and persons with typical development (TD). Questions remain regarding whether the age-related trajectories of EF in ASD are the same as or different from those in TD. To bridge this knowledge gap, we conducted a systematic review and meta-analyses of longitudinal studies that compared age-related changes in EF between ASD and TD groups (preregistration: osf.io/j5764). A literature search was conducted using PubMed, PsycINFO, and Web of Science on January 29, 2024. After screening by two independent reviewers, 14 longitudinal studies were included. Random-effects meta-analyses of studies involving a maximum total of 518 autistic and 3558 TD children and adolescents (mean baseline ages: 5.7-12.0 years) showed that ASD had significantly poorer EF than TD at both baseline and follow-up. However, there was no significant group difference in the age-related change in EF across domains, including working memory, inhibition, shifting, and planning. Robust Bayesian meta-analyses also provided substantial evidence in favor of the null hypothesis that ASD and TD groups showed similar changes over time for most EF processes. Limitations of the literature included the limited number of longitudinal studies and a narrow range of developmental stages and EF constructs analyzed across studies. Altogether, these findings suggest that autistic children and adolescents generally can improve in EF over time similarly to their neurotypical peers. This has important implications for parents and educators, encouraging appropriate EF training and intervention for autistic children and adolescents at an early stage.

Training kindergarten children on learning from their mistakes.

This study investigated whether feedback on their errors and speed improves kindergarten children's performance in an executive function (EF) task. Children from Switzerland (N = 213, 49% female, Mage = 6.4 years) were tested in the Hearts and Flowers task pre- and post-training and trained either on a variant of this task with (n = 71) or without feedback (n = 72), or on a control learning task (n = 70). The feedback group performed more efficiently than the no-feedback group during the intervention and partially also in the post-test. Both EF training groups performed more efficiently than the control group in the post-test. These results suggest that kindergarten children detect and monitor their errors and even get better at it given the opportunity to practice. Moreover, they benefit additionally from external feedback. Integrating feedback into computerized cognitive training (and learning apps) could be a potential avenue for interventions in school settings.

Effects of Executive Functions Training in Primary School Students with Borderline Intellectual Functioning Through a Multi-Method, Multi-Informant Intervention: A Pilot Study.

Borderline Intellectual Functioning (BIF) impacts cognitive functioning and adaptive behavior. Recent studies have demonstrated the efficacy of Executive Functions trainings to support daily-living skills in several clinical populations. However, although the relationship between Executive Functions and BIF has been studied, few studies have explored the effects of cognitive enhancement training for BIF children. Given the pivotal significance of Executive Functions in learning, orchestrating cognitive processes, and modulating affective and behavioral responses, our study aimed to evaluate the efficacy of cognitive enhancement training targeting Executive Functions in a group of 23 children diagnosed with Borderline Intellectual Functioning devoid of neurodevelopmental impairments. We included a multiple assessment based on several informants (children, teachers, parents, and tutors) and provided individualized cognitive enhancement training focused on Executive Functions through both digital and analog activities. The training was highly customized, structured and monitored at various stages of the process activities. The training was composed of 20 sessions, each lasting 2 hours, held twice a week for each child. The obtained results confirmed the efficacy of cognitive enhancement training in improving Executive Functions, the primary target of the intervention, particularly in attention, verbal fluency, planning, inhibitory control, working memory, and flexibility. Furthermore, improvements were observed by all the informants in other cognitive functions, learning, and adaptive behaviors. Our study contributes to the understanding of BIF, emphasizing the efficacy of neuropsychological enhancement through personalized training for EF.

Nonpharmacological interventions to improve the cognitive function among persons with traumatic brain injury: A systematic review.

The systematic review aimed to evaluate the effectiveness of nonpharmacological interventions (NPIs) for improving cognitive function among persons with traumatic brain injury. A systematic review. This systematic review was registered in PROSPERO and followed the PRISMA guideline. PubMed, ScienceDirect, Scopus, SpringerLink, Wiley Online Library, JSTOR, and Taylor & Francis were systematically searched for relevant articles of peer-reviewed studies published between 2008 and 2022. Two independent researchers conducted study selection, data extraction, and data quality assessment. Twenty-one studies met inclusion criteria, numbering a total of 757 participants. Six groups of NPIs were effective in improving cognitive functioning among persons with traumatic brain injury, including multimodal cognitive training, technology innovation, memory training, executive function training, physical activity, and sensory stimulation programs. Pooled evidence revealed that NPIs had a large effect on memory (d = 0.80, p < 0.05 to d = 2.03, p < 0.000), processing speed (d = 1.58, p < 0.05), and cognitive behavior (d = 1.63, p < 0.001 to d = 8.91, p 0.003). There was a medium effect on executive function (d = 0.5, p < 0.01 to d = 0.62, p < 0.05), attention (d = 0.5, p < 0.01), and intelligence (d = 0.57 to d = 0.59, p = 0.000). For visuospatial function and language, there was a significant increase post-intervention. Evidence from this systematic review indicates that NPIs, specifically the use of multimodal cognitive training and sensory stimulation programs, were effective in improving cognitive function outcomes among persons with traumatic brain injury, with medium to large effect sizes. Nonpharmacological interventions (NPIs) can enhance cognitive function in individuals with traumatic brain injury. These findings can guide healthcare professionals in clinical settings and support the development of technology applications for cognitive rehabilitation using NPIs.

The importance of Neuro-Cognitive Processing to the Understanding and Treatment of Child PTSD

Abstract Basic research and current clinical practice have revealed the difficulty in separating/connecting cognition and emotion and their respective localizations in the brain. Regarding Post-Traumatic Stress Disorder (PTSD), emotions (usually fear) cause a cascade of symptoms, including those impacting several cognitive processes. And it is often considered that relieving the emotional upset associated with PTSD will also improve related cognitive functioning. While it is often assumed that the relationship of emotion, cognition and PTSD is unidirectional, this may not necessarily be the case. The present article aims to describe the complex relationship between emotion and cognitive processes in those with PTSD and suggests an important role for executive functioning as a modulator of the emotion/cognition relationship, as well as the latter’s importance as a contributor to the successful treatment of PTSD. The paper concludes by stressing the importance of assessing cognitive processes in standard treatment protocols evaluating patients with PTSD and highlights the potential benefits of training executive functions as part of PTSD therapy. Keywords: PTSD, Cognitive processes, Emotion, Executive function, Neuropsychology.

Improving executive functions at school. Integrating metacognitive exercise in class and computerized training at home to ensure training intensity and generalization. A feasibility pilot study

AbstractPrevious research has demonstrated the effectiveness of executive functions (EFs) training, both in computer‐based and school‐based formats. However, there is limited research on the combined effects of these training modalities. This study aims to assess the feasibility and preliminary efficacy of an EFs training programme for primary school children. The programme includes computerized training sessions for home use and school activities with metacognitive elements. The study included a sample of 53 second‐grade children, with 21 children in the training group and 32 children in the control group. Feasibility questionnaires were completed by children, parents and teachers. The children also underwent an EFs evaluation. The results indicate that the training was enjoyable for children and feasible for parents and teachers. Furthermore, preliminary efficacy analysis revealed significant improvements in working memory. These findings suggest that the training model holds promise for enhancing EFs in children in the school context. Practitioner notesWhat is already known about this topic Individual differences in executive functions influence acquisitions, behaviours and competencies in several specific domains from infancy to adulthood. Enhancing executive functions during school‐age years can contribute to reducing or preventing academic, behavioural and social difficulties. Among interventions targeting executive functions in school‐aged children, school‐based interventions have shown the highest effectiveness, followed by metacognitive interventions and computer‐based interventions. What this paper adds This paper presents the implementation of an innovative school‐based training programme designed to improve executive functions (EFs). The programme combines metacognitive sessions conducted at school with computer‐based sessions carried out at home. The goal was to enhance the effectiveness and generalizability of the training. The training programme was found to be enjoyable for children and feasible for both parents and teachers. Preliminary efficacy data indicate promising results, suggesting that the training programme is effective in achieving its intended goals. Implications for practice and/or policy Integrating school‐based metacognitive training with computerized sessions delivered at home can provide a high‐intensity training programme that may not be achievable in the school context alone. The school activities, conducted in group settings with teachers and peers, were found to be the most appreciated by the children, indicating that computer sessions alone cannot replace the value of metacognitive sessions at school, within a meaningful social context for the child. It is crucial to actively involve families in the training process to ensure good adherence. Additionally, the availability of technological resources in each family should be evaluated before implementing the training programme.

Possible Connection between the Development of Executive Functions and Music Education According to the Kodály Concept

This research will focus on comparing tasks that are used to measure the development of executive functions (EFs) and musicianship exercises according to the Kodály concept in order to find analogies and functional intersections between them. EFs are essential for our mental and physical health, for school and job success. Since these skills can be improved and early EFs training might help reduce social disparities in academic achievement and health, pinpointing activities that could develop EFs has become an important research topic in psychology, neuroscience, and education in recent years. The main direction of this research will be a close examination of the tasks used for measuring the three core components of EFs - inhibition, cognitive flexibility and working memory alongside musicianship exercises taken from Kodály methodological books and lesson observations that work in a similar way. This study has found similarities between EF tasks and Kodály musicianship exercises in all the three core components of EFs. These findings could indicate that with Kodály’s music education approach we are not only practising musicianship exercises but we might challenge our EF skills as well. This research, therefore, could be a first step that leads to a more complex investigation into the potential positive impact of music education according to the Kodály Concept on EFs.

The association between music training and executive function in 6–7-year-old children

Executive function development is especially important in the last year of the preschool period because this period precedes the transition to school. Therefore, it is relevant to study extracurricular activities that can positively impact the development of executive function in 6–7-year-old children. According to earlier research, executive function development might be positively influenced by music training. The current cross-sectional study aimed to explore differences in executive function among 6–7-year-old preschoolers depending on participation in music training. In the current research, children were divided into two groups of 37 participants each: children who received music training for at least half a year and children who did not receive music training. Children in both groups did not participate in dance training because music is also actively used during dance training. Background variables such as participation in extracurricular activities, screen time, family singing activities, maternal education, and family income level did not differ between the groups. The study revealed that the children who received music training had a higher level of motor inhibitory control compared to the children who did not receive music or dance training. This study offers further support for the association between executive function and music training in preschoolers.

Efficacy of a virtual reality-based cognitive interactive training program for children with traumatic brain injuries: study protocol for a parallel-group randomized controlled trial

BackgroundTraumatic brain injury (TBI) is a leading cause of disability in children. Cognitive rehabilitation for this population is critical for their long-term health outcomes. This trial aims to evaluate the efficacy of a virtual reality-based program (VICT) for training executive functions in children with TBI.MethodsA parallel group randomized controlled trial will be conducted among up to 32 children with TBI. Children in the intervention group will receive the VICT training while children in the control group will play a comparable VR game without executive function training. Each participant will be assessed at baseline, post-intervention, and 1-month follow-up. Outcomes will include core executive functions, attention, and health-related quality of life measured by computerized tasks or standardized questionnaires.DiscussionCognitive rehabilitation is among the top healthcare needs for pediatric TBI patients. Virtual reality-based training is promising due to its versatile content, flexibility, and potential cost savings for both patients and providers. Findings of this trial will provide data on the efficacy of the VICT program on core executive functions, attention problems, and health-related quality of life and serve as the empirical foundation for future larger multi-site effectiveness trials.Trial registrationClinicalTrials.gov NCT04526639. Registered on August 18, 2020.

Prototype of a digital game for training executive functions in students with cerebral palsy

O objetivo deste estudo foi desenvolver e validar um protótipo de um jogo digital como recurso de Tecnologia Assistiva para o treinamento das funções executivas de memória de trabalho e atenção seletiva em estudantes com paralisia cerebral. Para tanto, o estudo foi desenvolvido em três etapas. A primeira etapa consistiu na análise de um conjunto de diretrizes na literatura que contemplavam informações sobre o desenvolvimento de jogos digitais para estudantes com paralisia cerebral. Na segunda etapa, foi desenvolvido o protótipo do jogo digital na plataforma livre Engine GDevelop, disponível para a construção de jogos digitais. E, na terceira etapa, ocorreu a validação do protótipo do jogo digital junto a especialistas na área de Educação Especial e de jogos, onde foi formado um grupo de discussão composto por seis avaliadoras com experiência em intervenções com estudantes com paralisia cerebral. Os resultados demonstraram que após o consenso do grupo, foi recomendado pelas avaliadoras algumas modificações no desenvolvimento do protótipo. Desse modo, pôde-se concluir que o protótipo do jogo digital atende às funções executivas propostas e pode ser considerado como recurso de Tecnologia Assistiva para o treinamento de estudantes com paralisia cerebral compreendidas até o nível 3 de GMFCS e MACS.

A Systematic Literature Review of the Impact of Cognitive Stimulation Programs on Reading Skills in Children Aged between 6 and 12 Years Old

The scientific evidence regarding the possibility of transferring benefits derived from cognitive training focused on working memory and inhibitory control to reading skills in children aged 6 to 12 is inconclusive. This study carries out a systematic review of recent published studies on this topic with the aim of analysing the specific role of various cognitive stimulation programs in the growth of executive functions and reading performance in children from ages 6 to 12. Here, we present the main results reported in the most recent literature, where the impact of intervention programs on working memory and inhibitory control in children with typical development are analysed. Even though the effectiveness of executive function training programs in terms of close transfer is conspicuous, there is still a lack of convergence in recently published articles, especially regarding the effects of far transfer in reading comprehension after cognitive stimulation programs are applied.

Combining executive function training and anomia therapy in chronic post-stroke aphasia: A preliminary study of multidimensional effects

Purpose The influential relationship between executive functioning and aphasia rehabilitation outcomes has been addressed in a number of studies, but few have studied the effect of adding executive function training to linguistic therapies. The present study aimed to measure the effects of combining, within therapy sessions, executive function training and anomia therapy on naming and discourse abilities in people with chronic aphasia. Method A single-case experimental design with multiple baselines across participants was used. Four persons with chronic post-stroke aphasia received 12 sessions of a tailored treatment combining executive function training and semantic feature analysis (SFA) therapy. Naming accuracy of treated items was examined over the course of the treatment while control naming scores of untreated items and discourse measures were collected pre-treatment, immediately post-treatment, and 4 weeks post-treatment, in order to investigate the multidimensional effects of the treatment and their maintenance. Result Naming skills improved in all participants for treated and untreated items, were maintained over time, and were accompanied by improved discourse abilities. Visual and statistical analyses showed a significant treatment effect for naming skills in three out of the four participants. Conclusion A combination of executive function training and SFA treatment in people with chronic aphasia may improve both naming skills and discourse efficiency. Further studies are needed to substantiate these promising preliminary results.

Training Executive Functions Within the Mathematical Domain: A Pilot Study with an Integrated Digital‐Paper Procedure in Primary Second‐Grade

AbstractInterventions targeting cognitive control processes, such as Executive Functions (EF) have recently been experimented to enhance early math skills. This pilot study explored the feasibility and effectiveness of an intervention integrating EF activities into the mathematical domain among second‐grade students. One hundred and four typically‐developing‐children were assigned to either a group that underwent the intervention (Trained Group; n = 58) or a group that continued with daily didactic activities (Control Group; n = 46). The training lasted for 8 weeks and included both home‐based digital and school‐based paper activities. According to teachers' feedback, the intervention was highly appreciated by children and compatible with classical school curricula. The Trained Group improved in behavioral self‐regulation, math abilities and problem‐solving in comparison to the Control Group. Notably, within the Trained Group, benefits of the training were higher in children with high working memory. This training offers a model to support math learning in primary school, considering inter‐individual differences in EF.

Enhancing Selective Attention in Children with Learning Disorders: Efficacy of Executive Functions Training

The study aimed to evaluate the effectiveness of an executive functions training program in improving selective attention among children with specific learning disorders. It sought to assess the immediate and sustained impacts of the intervention by comparing changes in selective attention scores between experimental and control groups across pre-test, post-test, and follow-up measurements. A total of 40 children diagnosed with specific learning disorders were recruited and randomly assigned to either the experimental (n=20) or control (n=20) groups. The experimental group underwent a comprehensive executive functions training program, while the control group received no intervention. Selective attention was assessed for all participants at three time points: pre-test, immediately post-intervention (post-test), and at a follow-up session. Descriptive statistics, mixed-model Analysis of Variance (ANOVA), and Bonferroni post-hoc tests were employed to analyze the data. The experimental group demonstrated significant improvements in selective attention scores from pre-test to post-test (mean difference = 6.40, p = 0.001) and maintained these improvements at follow-up (mean difference = 6.55, p = 0.001). In contrast, the control group showed minimal changes across the same periods. Statistical analyses confirmed significant effects of time, group, and time × group interaction on selective attention scores, with large effect sizes (Eta² &gt; 0.37) indicating the substantial impact of the intervention. The executive functions training program was highly effective in enhancing selective attention among children with specific learning disorders. The intervention led to significant and sustained improvements, highlighting the potential of targeted cognitive training in supporting children with learning challenges. These findings suggest that incorporating executive functions training into therapeutic and educational strategies for children with learning disorders could substantially benefit their cognitive development and academic performance.

Executive Functions Assessment Based on Wireless EEG and 3D Gait Analysis During Dual-Task: A Feasibility Study.

Executive functions (EFs) are neurocognitive processes planning and regulating daily life actions. Performance of two simultaneous tasks, requiring the same cognitive resources, lead to a cognitive fatigue. Several studies investigated cognitive-motor task and the interference during walking, highlighting an increasing risk of falls especially in elderly and people with neurological diseases. A few studies instrumentally explored relationship between activation-no-activation of two EFs (working memory and inhibition) and spatial-temporal gait parameters. Aim of our study was to detect activation of inhibition and working memory during progressive difficulty levels of cognitive tasks and spontaneous walking using, respectively, wireless electroencephalography (EEG) and 3D-gait analysis. Thirteen healthy subjects were recruited. Two cognitive tasks were performed, activating inhibition (Go-NoGo) and working memory (N-back). EEG features (absolute and relative power in different bands) and kinematic parameters (7 spatial-temporal ones and Gait Variable Score for 9 range of motion of lower limbs) were analyzed. A significant decrease of stride length and an increase of external-rotation of foot progression were found during dual task with Go-NoGo. Moreover, a significant correlation was found between the relative power in the delta band at channels Fz, C4 and progressive difficulty levels of Go-NoGo (activating inhibition) during walking, whereas working memory showed no correlation. This study reinforces the hypothesis of the prevalent involvement of inhibition with respect to working memory during dual task walking and reveals specific kinematic adaptations. The foundations for EEG-based monitoring of cognitive processes involved in gait are laid. Clinical and Translational Impact Statement: Clinical and instrumental evaluation and training of executive functions (as inhibition), during cognitive-motor task, could be useful for rehabilitation treatment of gait disorder in elderly and people with neurological disease.